Factors Promoting Futile Recanalization After Stent Retriever Thrombectomy for Stroke Affecting the Anterior Circulation: A Retrospective Analysis

World Neurosurg. 2020 Jan:133:e576-e582. doi: 10.1016/j.wneu.2019.09.098. Epub 2019 Sep 24.

Abstract

Objective: To investigate the factors associated with futile recanalization after stent retriever thrombectomy in patients with acute ischemic stroke due to large vessel occlusion.

Methods: We retrospectively analyzed the medical records of 56 patients with an acute anterior circulation macrovascular occlusion who underwent successful stent retriever thrombectomy. Patients were classified as successful recanalization or futile recanalization at the follow-up. Univariate analysis and binary logic regression analysis were used to explore the association between patients' demographic and clinical characteristics and futile recanalization.

Results: The rate of futile recanalization was significantly higher after stent retrieval thrombectomy in patients with an Alberta Stroke Program Early CT (ASPECT) score ≤7 points versus >7 points (P < 0.001), ≥5 passes with the stent retriever versus <5 passes with the stent retriever (P = 0.036), or a longer recanalization time (P = 0.008). The influence of number of stent retriever pass is foremost, followed by ASPECT and occurrence to recanalization.

Conclusions: Improving technical expertise with mechanical thrombectomy and shortening the therapeutic time window may improve the prognosis of patients with acute ischemic stroke due to large vessel occlusion.

Keywords: Acute anterior circulation; Futile recanalization; Large vessel occlusion; Stent retriever thrombectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Stents
  • Stroke / surgery*
  • Thrombectomy / methods*
  • Treatment Outcome*